HI Elizabeth, i agree with Sue. I've had a tsh below 1 (.04 when last month) for quite a while now and i feel good at that level. Sometimes it takes a while to find that magic number for yourself. It also takes a dr. that goes by how you feel and not what the labs say. My dr. looks at both the tsh and ft4to determine if i'm at the right dose. Are you new to the total replacement, no thyroid game? take care...phyllis

I had a TT Dec 27.I did not have cancer. Just benign cysts and nodules. I took replacement for over a year before the surgery.

I'm very new to the no thyroid game.

I'm lucky to have a Doc who goes by my symptoms and when she does bloodwork she checks TSH, T3 and T4.

I take armour thyroid.

90 mg/ am
60 mg/ afternoon

My tsh stays way below 1
Last time it was 0.006 My T3 and T4's always look great though.
I did have that last test mid afternoon after I already took my meds and usually I have my blood drawn first thing in the morning before I take my meds.
The bloodwork before that last one which I had first thing in the morning showed my tsh at 0.049

This is a really interesting question. Since TSH is a hormone produced by the pituitary gland to STIMULATE the thryoid to produce more hormone, then in the absence of a thyroid, I would think the TSH would be a useless indicator. You probably already know this, but when the pituitary sees that the body is in need of more thryoid hormone, it produces TSH to stimulate the thyroid to produce T4, which the body then converts to T3 and the others (T2, T1). Since theoretically, if the TSH is high, the pituitary is trying to get the thyroid to produce more hormone. If it is low, the pituitary is NOT trying to stimulate the thyroid because it perceives too much hormone in circulation. That's why, when docs see a low TSH, they ASSUME there is too much circulating thyroid hormone. When they see a high TSH, they assume there is too little circulating hormone.

Unfortunately, I think some smart docs are beginning to realize that it is not that neat and clean. Many people, like me, can have beautiful TSH's of 1.6, with free T3 and T4 in the basement. For some reason, my pituitary didnt' care that I had hardly any thryoid hormone in my blood. So, I don't believe the TSH is a great indicator of thyroid health even WITH a thyroid gland, let alone without one!

It would seem to me that the actual hormone circulating in the blood, for use by the cells, would be the more accurate guage whether one has a thyroid or not - the free t3 and free t4.

My thyroid is being supressed altogether, to keep my nodule down. My doc does the TSH, but it is naturally undetectable - he goes by the Free T3 and T4, and by how I feel. My other docs freak out, of course, because they are so married to the TSH. THey see the low TSH and immediately assume that I am hyperthyroid, without ever checking the free values.

I am scheduled for at TT in a few weeks, and so your question interests me. I am interested in hearing from others who do not have a thryoid, how their docs regulate their hormone levels.

Thanks for the words of encouragement. Did your surgery help any with symptoms that the thryoid replacement wasn't helping? For example, I have been on replacement for 3 years now, and some things have resolved, like hair loss, heartburn, dry skin. But I still have tons of fatigue, weight gain, muscle/joint pain, brain fog. No matter at what does I am, these things don't get better. I don't know what else to do. But I know that this notion that the TSH is THE gold-standard for detecting thyroid disease, and for regulating exogeneous thyroid hormone, is lunacy that has caused untold suffering.

If I were you, I wouldn't worry about the low TSH, as long as your Free's are normal range, and you feel good.

I've got tears in my eyes! To even IMAGINE that, after 17 years, I might have some freedom from all the misery, is almost too much! I am so afraid that I will feel worse, and I can barely make it now! And I am afraid to get my hopes up too high, or I will become completely depressed if I don't feel better. Your post has given me another indicator that I CAN have hope!

I am so happy for you, that most of your symptoms resolved! I have heard of others, and it gives me HOPE. Did it take a long time for you to feel better, or was it right away? My cousin said it was about 3 months before all her symptoms went away, but she was not on any thyroid hormone before the surgery, and it took them 3 months to get her regulated - and as soon as she got the right amount of thyroid hormone, she said she felt wonderful.

Thank you SO MUCH for cheering me on! I am SO READY to feel like a human being again - I have forgotten what it feels like to feel "good."